aiea.driftzoneint.com
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2606:4700:4400::6812:235a
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URL:
https://aiea.driftzoneint.com/
Submission: On November 18 via api from US — Scanned from GB
Submission: On November 18 via api from US — Scanned from GB
Form analysis 1 forms found in the DOM
Name: builder-form —
<form id="_builder-form"
style="background-color:#FFFFFFFF;color:#undefined;border:1px none #CDE0EC;border-radius:8px 8px 0 0;max-width:550px;width:100%;margin-top:;border-color:#CDE0EC;padding-top:20px;padding-bottom:0px;padding-left:40px;padding-right:40px;box-shadow:0;margin-bottom:0;"
name="builder-form" class="ghl-survey-form" data-v-d9fad203=""><!---->
<div class="ghl-question-set" style="margin-top:2px;" data-v-d9fad203=""><!--[-->
<div class="ghl-page-current slide-no-1 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:13px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p><em>You must be 18 years or older to sign. Minors must be checked in by a parent or legal guardian.</em></p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-first_name" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">First Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="first_name" class="form-control" id="first_name" data-q="first_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-last_name" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Last Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="last_name" class="form-control" id="last_name" data-q="last_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-phone" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Phone <span>*</span></label>
<div class="flex-col">
<div class="flex phone-input" style=""><input type="tel" name="phone" placeholder="" autocomplete="off" class="form-control" id="phone" data-q="phone" data-required="true"><!----></div><!----><!----><!---->
</div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item field-container form-builder--item-input" data-v-d9fad203=""><!----><label class="label-alignment">Email <span>*</span></label>
<div class="flex-col">
<div class="flex email-input"><input placeholder="" name="email" type="email" class="form-control" data-q="email" data-required="true"><!----></div><!----><!----><!---->
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="f4c9-1bdf-NativeDatePicker" id="f4c9-1bdf-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="date_of_birth"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="date_of_birth" data-required="true"><!----><!----></div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item" data-v-d9fad203="">
<div class="terms-and-conditions"><input id="terms_and_conditions_ku6pwi6pb5" value="terms_and_conditions" name="terms_and_conditions" type="checkbox" data-q="terms_and_conditions" data-required="true"><span
style="font-family:Inter;margin-left:10px;" for="terms_and_conditions_ku6pwi6pb5"><span style="color: #000000;">
<p><em>I consent to receive SMS notifications, alerts & occasional marketing communications. Message frequency varies. Message & data rates may apply. You can reply STOP to unsubscribe.</em></p>
</span></span></div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:12px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p><em>If you wish to complete the waiver without opting into marketing messages, please see our staff. We will provide additional options.</em></p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have children you need to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_etO96sDgy840thdZwE3R_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_children_under_18_years_old_you_need_to_sign_for" data-required="true"><label
style="margin-left:10px;" for="Yes_etO96sDgy840thdZwE3R_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_etO96sDgy840thdZwE3R_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_children_under_18_years_old_you_need_to_sign_for" data-required="true"><label style="margin-left:10px;"
for="No_etO96sDgy840thdZwE3R_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-2 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 1</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-6dvASHwdq5NR8Gj0hfuS" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="6dvASHwdq5NR8Gj0hfuS" class="form-control" id="6dvASHwdq5NR8Gj0hfuS" data-q="minor_#1_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="7d6a-4583-NativeDatePicker" id="7d6a-4583-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="Y3qMLSAnHr5SBE7mgElt"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_#1_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have another child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_W5OO6CXWNxiuftpW8ygp_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_another_child_to_sign_for" data-required="true"><label style="margin-left:10px;"
for="Yes_W5OO6CXWNxiuftpW8ygp_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_W5OO6CXWNxiuftpW8ygp_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_another_child_to_sign_for" data-required="true"><label style="margin-left:10px;"
for="No_W5OO6CXWNxiuftpW8ygp_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-3 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 2</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-jyNG6mgPYRLaCX7o6nTv" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="jyNG6mgPYRLaCX7o6nTv" class="form-control" id="jyNG6mgPYRLaCX7o6nTv" data-q="minor_#2_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="ab15-0048-NativeDatePicker" id="ab15-0048-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="cBXZRtIisSyFiKhnnaSJ"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_#2_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have another child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_TZCjLmMFN6TXfurpHD4I_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_another_child_to_sign_for1" data-required="true"><label style="margin-left:10px;"
for="Yes_TZCjLmMFN6TXfurpHD4I_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_TZCjLmMFN6TXfurpHD4I_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_another_child_to_sign_for1" data-required="true"><label style="margin-left:10px;"
for="No_TZCjLmMFN6TXfurpHD4I_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-4 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 3</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-TdfNEq52nYSORf79fHqU" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="TdfNEq52nYSORf79fHqU" class="form-control" id="TdfNEq52nYSORf79fHqU" data-q="minor_#3_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="5f78-68cc-NativeDatePicker" id="5f78-68cc-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="qTFEASQUQ7gFM17x2gqA"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_#3_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have another child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_jOB0OsuuTAgA8G21eSQz_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="checkbox_7avs" data-required="true"><label style="margin-left:10px;"
for="Yes_jOB0OsuuTAgA8G21eSQz_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_jOB0OsuuTAgA8G21eSQz_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="checkbox_7avs" data-required="true"><label style="margin-left:10px;"
for="No_jOB0OsuuTAgA8G21eSQz_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-5 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 4</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-W7dEXsuQTSBZ9dkUmXej" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="W7dEXsuQTSBZ9dkUmXej" class="form-control" id="W7dEXsuQTSBZ9dkUmXej" data-q="minor_#4_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="d72b-216d-NativeDatePicker" id="d72b-216d-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="0GuwH3QvsEY0VLGPxVJb"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_#4_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have another child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_CX3uCGGmuebHWjSimI8r_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_another_child_to_sign_for2" data-required="true"><label style="margin-left:10px;"
for="Yes_CX3uCGGmuebHWjSimI8r_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_CX3uCGGmuebHWjSimI8r_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_another_child_to_sign_for2" data-required="true"><label style="margin-left:10px;"
for="No_CX3uCGGmuebHWjSimI8r_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-6 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 5</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-YyYTHII5pmIcMeOk8Q8C" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="YyYTHII5pmIcMeOk8Q8C" class="form-control" id="YyYTHII5pmIcMeOk8Q8C" data-q="minor_#5_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="4772-6167-NativeDatePicker" id="4772-6167-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="PhXTa7ltMLflo7Yy8VRj"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_#5_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have a sixth child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_oL2FqQin5qe1p6NMEfCJ_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_a_sixth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="Yes_oL2FqQin5qe1p6NMEfCJ_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_oL2FqQin5qe1p6NMEfCJ_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_a_sixth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="No_oL2FqQin5qe1p6NMEfCJ_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-7 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 6</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-DzlKGVxrJ1wtHVYY18sV" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="DzlKGVxrJ1wtHVYY18sV" class="form-control" id="DzlKGVxrJ1wtHVYY18sV" data-q="minor_6:_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="8666-1813-NativeDatePicker" id="8666-1813-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="3AFIaY71aQ6KhCAohNs0"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_6:_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have a seventh child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_lzXEKmcsTRcERLsVPjgS_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_a_seventh_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="Yes_lzXEKmcsTRcERLsVPjgS_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_lzXEKmcsTRcERLsVPjgS_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_a_seventh_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="No_lzXEKmcsTRcERLsVPjgS_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-8 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 7</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-sKO7VnFeOGWmOFu2lwTU" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="sKO7VnFeOGWmOFu2lwTU" class="form-control" id="sKO7VnFeOGWmOFu2lwTU" data-q="minor_7:_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="5544-c498-NativeDatePicker" id="5544-c498-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="wN3oafde45HckDLjxNbS"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_7:_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have a eighth child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_T0BhTDWvLFT0cXV1RyQb_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_a_eighth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="Yes_T0BhTDWvLFT0cXV1RyQb_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_T0BhTDWvLFT0cXV1RyQb_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_a_eighth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="No_T0BhTDWvLFT0cXV1RyQb_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-9 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 8</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-TvpLZ0JarJq5EJml9Q8T" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="TvpLZ0JarJq5EJml9Q8T" class="form-control" id="TvpLZ0JarJq5EJml9Q8T" data-q="minor_8:_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="562e-7a96-NativeDatePicker" id="562e-7a96-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="XzXw7KYplrXlEoERBXiw"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_8:_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have a ninth child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_HudMrMR5bkR2T5emh8ga_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_a_ninth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="Yes_HudMrMR5bkR2T5emh8ga_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_HudMrMR5bkR2T5emh8ga_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_a_ninth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="No_HudMrMR5bkR2T5emh8ga_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-10 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 9</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-JTaMU5WzHnPN0889eyyP" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="JTaMU5WzHnPN0889eyyP" class="form-control" id="JTaMU5WzHnPN0889eyyP" data-q="minor_9:_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="f86b-172c-NativeDatePicker" id="f86b-172c-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="Fpp2XEi2ZK9ksueBKVDx"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_9:_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label class="field-label label-alignment">Do you have a tenth child to sign for? <span>*</span></label>
<div class="flex-col">
<div style="width:100%;"><!--[-->
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="Yes_W7J1F3ce2GCnSrBJxJBE_0_ku6pwi6pb5" value="Yes" name="Yes" type="checkbox" data-q="do_you_have_a_tenth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="Yes_W7J1F3ce2GCnSrBJxJBE_0_ku6pwi6pb5">Yes</label></div>
</div>
<div style="position:relative;display:inline-block;width:100%;">
<div class="in-r-c"><input id="No_W7J1F3ce2GCnSrBJxJBE_1_ku6pwi6pb5" value="No" name="No" type="checkbox" data-q="do_you_have_a_tenth_child_to_sign_for?" data-required="true"><label style="margin-left:10px;"
for="No_W7J1F3ce2GCnSrBJxJBE_1_ku6pwi6pb5">No</label></div>
</div><!--]-->
</div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-11 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Montserrat';font-size:30px;font-weight:600;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>Child 10</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203="">
<div data-v-d9fad203="">
<div class="field-container">
<div id="form-QWYIpCufblqOFHW1vnmM" class="form-builder--item-input form-builder--item"><!----><label class="label-alignment">Name <span>*</span></label>
<div class="flex-col"><input type="text" placeholder="" name="QWYIpCufblqOFHW1vnmM" class="form-control" id="QWYIpCufblqOFHW1vnmM" data-q="minor_10:_name" data-required="true"><!----></div><!----><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-d9fad203=""><!----><label style="" for="9d2b-c2f7-NativeDatePicker" id="9d2b-c2f7-label" class="label-alignment">Birthdate <span>*</span></label>
<div class="flex-col">
<div class="vdpWithInput vdpComponent date-picker-custom-style date-picker-field-survey" name="pntGDOuijRG94tW9wUHy"><input value="" placeholder="MM/DD/YYYY" type="text" data-q="minor_10:_birthdate" data-required="true"><!----><!---->
</div><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="slide-no-12 form-builder--wrap-questions ghl-question" data-v-d9fad203="">
<div class="fields-container row" data-v-d9fad203=""><!--[-->
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:15px;font-weight:400;text-align:left;padding:0px 0px 0px 0px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p><strong>ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES RELEASE AND WAIVER OF LIABILITY, INDEMNITY AND ASSUMPTION OF RISK AGREEMENT (“AGREEMENT”)</strong></p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:12px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>IN CONSIDERATION of participating in any driving, foam dart/foam ball blaster play, and other activities including but not limited to, participating, using the premises of, renting and operating equipment leased sanctioned and/or
operated by ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES, I represent and acknowledge that I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to
participate in such Activity. I acknowledge that if I believe that event or Activity conditions are unsafe, I will immediately discontinue participating in the Activity. I fully understand that this Activity involves risks of
serious bodily injury, including permanent disability, strains, fractures, eye injury, blindness, heat stroke, heart attack, paralysis and death, which may be caused by my own actions, or inaction, those of others participating in
the Activity, the conditions in which the Activity takes place, or the negligence of the “releases” named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept
and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of participation in the Activity.</p>
<p><br></p>
<p>I hereby release, discharge, and covenant not to sue ICE SAFE CORP, its Respective members, administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, owners and lessors
of premises on which the Activity takes place, (each considered one of the “RELEASES” herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the
negligence of the “releases” or otherwise, including negligent rescue operations; and I further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf makes a claim against any
of the Releases, I will indemnify, save, and hold harmless each of the Releases from any loss, liability, damage, or cost which any may incur as the result of such claim.</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:15px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p><strong>Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 </strong></p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:12px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, Federal,
State and local governments health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES has put in place
preventative measures to reduce the spread of COVID-19; however, ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further,
attending the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19
and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES and that such exposure or infection may result in
personal injury, illness, permanent disability and death. I understand the risk of becoming exposed to or infected by COVID-19 at ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES may result from the actions,
omissions, or negligence of myself and others, including, but not limited to, ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES employees, volunteers, and programs participants and their families. I voluntarily agree
to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or
expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the ICE SAFE CORP dba DRIFT ZONE INTERNATIONAL or participation in ICE SAFE CORP dba DRIFT ZONE, dba RAZOR
SPORTS, dba RAZOR GAMES programming (“CLAIMS”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES,
its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release
includes and Claims based on the actions, omissions, or negligence of the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES, its employees, agents, and representatives, whether a COVID-19 infection occurs before,
during, or after participation in any ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES program.</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:15px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p><strong>Image/Video/Audio Use Clause</strong></p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:12px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>I hereby give ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES permission to take photographs/video of me or photographs/video in which I may be involved with others for the purpose of promoting ICE SAFE CORP dba
DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES. Furthermore I hereby release and discharge ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES and all its agents from any and all claim arising out of use of the
photographs/video. In this regard I declare that I am above the age of 18. I have read the foregoing document and fully understand its contents. </p>
<p><br>I have read this RELEASE AND WAIVER OF LIABILITY, INDEMNITY, AND ASSUMPTION OF RISK AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without and inducement or assurance
of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the Balance, notwithstanding,
shall continue in full force and effect.</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:15px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p><strong>PARENTAL CONSENT </strong></p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-odd form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item heading-element" data-v-d9fad203="">
<div class="text-element"
style="color:#000000;background-color:#FFFFFF;border:0px none #FFFFFF;border-radius:0px;font-family:'Roboto';font-size:12px;font-weight:400;text-align:left;padding:0px 20px 0px 20px;box-shadow:0px 0px 0px 0px #FFFFFF;line-height:1.5;">
<div>
<p>AND I the minor’s parent and / or legal guardian, understand the nature of the above referenced activities and the minor’s experience and capabilities and believe the minor to be qualified to participate in such activity. I
hereby release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releases from all liability, claims, demands, losses, or damages on the minor’s account caused or alleged to have been
caused in whole or in part by the negligence of the releases or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the parent, legal guardian, minor, or anyone on the minor’s
behalf makes a claim against any of the above Releases, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releases from any litigation expenses, attorney fees, loss, liability, damage, or cost any Release may incur as the
result of any such claim.</p>
</div>
</div>
</div><!---->
</div>
</div>
<div class="col-12 form-field-wrapper" style="margin-bottom:16px;" data-v-d9fad203="">
<div class="f-even form-field-container" data-v-d9fad203=""><!---->
<div class="form-builder--item" data-v-d9fad203=""><!----><label class="label-alignment">Signature <span>*</span></label>
<div class="flex-col">
<section class="signature-container"><span></span><a aria-label="Clear" class="clear-button">Clear</a></section><!----><!---->
</div><!---->
</div>
<div class="field-divider" data-v-d9fad203=""></div>
</div>
</div><!--]-->
</div>
</div><!--]-->
</div><!----><!---->
</form>Text Content
All Riders Must Complete a Waiver If you have any questions, please speak with one of our staff members or call . You must be 18 years or older to sign. Minors must be checked in by a parent or legal guardian. First Name * Last Name * Phone * Email * Birthdate * I consent to receive SMS notifications, alerts & occasional marketing communications. Message frequency varies. Message & data rates may apply. You can reply STOP to unsubscribe. If you wish to complete the waiver without opting into marketing messages, please see our staff. We will provide additional options. Do you have children you need to sign for? * Yes No Child 1 Name * Birthdate * Do you have another child to sign for? * Yes No Child 2 Name * Birthdate * Do you have another child to sign for? * Yes No Child 3 Name * Birthdate * Do you have another child to sign for? * Yes No Child 4 Name * Birthdate * Do you have another child to sign for? * Yes No Child 5 Name * Birthdate * Do you have a sixth child to sign for? * Yes No Child 6 Name * Birthdate * Do you have a seventh child to sign for? * Yes No Child 7 Name * Birthdate * Do you have a eighth child to sign for? * Yes No Child 8 Name * Birthdate * Do you have a ninth child to sign for? * Yes No Child 9 Name * Birthdate * Do you have a tenth child to sign for? * Yes No Child 10 Name * Birthdate * ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES RELEASE AND WAIVER OF LIABILITY, INDEMNITY AND ASSUMPTION OF RISK AGREEMENT (“AGREEMENT”) IN CONSIDERATION of participating in any driving, foam dart/foam ball blaster play, and other activities including but not limited to, participating, using the premises of, renting and operating equipment leased sanctioned and/or operated by ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES, I represent and acknowledge that I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe that event or Activity conditions are unsafe, I will immediately discontinue participating in the Activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, strains, fractures, eye injury, blindness, heat stroke, heart attack, paralysis and death, which may be caused by my own actions, or inaction, those of others participating in the Activity, the conditions in which the Activity takes place, or the negligence of the “releases” named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of participation in the Activity. I hereby release, discharge, and covenant not to sue ICE SAFE CORP, its Respective members, administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, owners and lessors of premises on which the Activity takes place, (each considered one of the “RELEASES” herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the “releases” or otherwise, including negligent rescue operations; and I further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf makes a claim against any of the Releases, I will indemnify, save, and hold harmless each of the Releases from any loss, liability, damage, or cost which any may incur as the result of such claim. Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, Federal, State and local governments health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES has put in place preventative measures to reduce the spread of COVID-19; however, ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES and that such exposure or infection may result in personal injury, illness, permanent disability and death. I understand the risk of becoming exposed to or infected by COVID-19 at ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES may result from the actions, omissions, or negligence of myself and others, including, but not limited to, ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES employees, volunteers, and programs participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the ICE SAFE CORP dba DRIFT ZONE INTERNATIONAL or participation in ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES programming (“CLAIMS”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes and Claims based on the actions, omissions, or negligence of the ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES program. Image/Video/Audio Use Clause I hereby give ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES permission to take photographs/video of me or photographs/video in which I may be involved with others for the purpose of promoting ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES. Furthermore I hereby release and discharge ICE SAFE CORP dba DRIFT ZONE, dba RAZOR SPORTS, dba RAZOR GAMES and all its agents from any and all claim arising out of use of the photographs/video. In this regard I declare that I am above the age of 18. I have read the foregoing document and fully understand its contents. I have read this RELEASE AND WAIVER OF LIABILITY, INDEMNITY, AND ASSUMPTION OF RISK AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without and inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the Balance, notwithstanding, shall continue in full force and effect. PARENTAL CONSENT AND I the minor’s parent and / or legal guardian, understand the nature of the above referenced activities and the minor’s experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releases from all liability, claims, demands, losses, or damages on the minor’s account caused or alleged to have been caused in whole or in part by the negligence of the releases or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the parent, legal guardian, minor, or anyone on the minor’s behalf makes a claim against any of the above Releases, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releases from any litigation expenses, attorney fees, loss, liability, damage, or cost any Release may incur as the result of any such claim. Signature * Clear NEXT © DRIFTZONE - ALL RIGHTS RESERVED | PRIVACY POLICY